Home-based versus centre-based cardiac rehabilitation

Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Zawada, Anna; Dean, Sarah; Cowie, Aynsley; Norton, Rebecca J

doi:10.1002/14651858.cd007130.pub3

Cited by 123 publications

(90 citation statements)

References 71 publications

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“…They are also shown to be efficacious [104][105][106][107] . The offering of alternative models was first reported in a 1997 publication from England and Wales 25 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

A Review of Cardiac Rehabilitation Delivery Around the World

Pesah

Supervía

Turk-Adawi

et al. 2017

Progress in Cardiovascular Diseases

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Herein, 28 publications describing cardiac rehabilitation (CR) delivery in 50 of the 113 countries globally suspected to deliver it are reviewed, to characterize the nature of services. Government funding was the main source of CR reimbursement in most countries (73%), with private and patient funding in about ¼ of cases.Myocardial infarction patients and those having revascularization were commonly served. The main professions delivering CR were physicians, nurses, and physiotherapists. Programs offered a median of 20 sessions, although this varied. Most programs offered the core components of exercise training, patient education and nutrition counselling. Alternative models were not commonly offered. Lack of human and/or financial resources as well as space constraints were reported as the major barriers to delivery. Overall, CR delivery has been characterized in less than half of the countries where it is offered. The nature of services delivered is fairly consistent with major CR guidelines and statements.Keywords: cardiac rehabilitation, global health, secondary prevention Alphabetical List of Abbreviations: AS= administrative support CABG = coronary artery bypass graft CB = community-based A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT2 CR = cardiac rehabilitation CPR= cardiopulmonary resuscitation CVD = cardiovascular disease ECG = electrocardiogram EQ= equipment ET = exercise training FR= financial resources HB = home-based HF = heart failure HR= human resources IA = initial assessment IB = internet-based IHD = ischemic heart disease LMIC = low-and middle-income country MI = myocardial infarction NC = nutrition counseling NZ = New Zealand PAW= patient awareness PCI = percutaneous coronary intervention PE = patient education PR= patient referral RF = risk factor management SC = smoking cessation SM = stress management and/or psychosocial support/counselling TI = transportation issues UAE = United Arab Emirates VAD = ventricular assist device A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT3 By 2030, it is expected 84 million individuals will be diagnosed with cardiovascular disease (CVD) 1 .Moreover, it is among the leading causes of disability around the world, and contributes to 10% of disabilityadjusted life years lost world-wide 2 . With improved survival (in high-income countries 3 ), clearly there is a great need for secondary prevention, such as is offered in cardiac rehabilitation (CR) programs.Many meta-analyses demonstrate that participation in CR is associated with improved quality of life, as well as decreased morbidity and mortality [4][5][6][7] . CR is also cost-effective 8 . Accordingly, it is a class 1 level A recommendation in clinical practice guidelines for CVD patients 9,10 . 19 , have established guidelines to ensure consistent provision and quality of CR delivery in order to achieve the greatest population health benefits. They all outline the nature of patients indicated for services, and make recommendations regarding the composition of a multi-disciplinary...

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“…They are also shown to be efficacious [104][105][106][107] . The offering of alternative models was first reported in a 1997 publication from England and Wales 25 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

A Review of Cardiac Rehabilitation Delivery Around the World

Pesah

Supervía

Turk-Adawi

et al. 2017

Progress in Cardiovascular Diseases

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“…A disponibilidade de programas realizados em casa ou em locais próximos do ambiente domiciliar oferece uma oportunidade de ampliar o acesso e participação na RCPM. [11][12][13] Tendo em vista o exposto, este estudo tem por objetivo verificar e comparar a aderência a um programa de reabilitação baseado a domicilio e identificar as barreiras que interferem na adesão. Após análise dos diários de treinamento físico foi possível observar que, um participante do GC precisou ser excluído da amostra final uma vez que este apresentou problemas de saúde durante a intervenção proposta (Crise de Otite).…”

Section: Introductionunclassified

Análise da aderência em diferentes programas de reabilitação cardíaca: estudo preliminar

et al. 2016

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Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4. RESUMOUltimamente tem se optado por exercícios de reabilitação baseada em domicílio como alternativa para a reabilitação cardiopulmonar e metabólica (RCPM). Objetivo: verificar e comparar a aderência a um programa de reabilitação, baseado a domicilio e identificar as barreiras que interferem na adesão. Método: ensaio clí-nico controlado -estudo preliminar. Foram recrutados 11 pacientes diagnosticados com doença arterial coronariana (DAC), sedentários a pelo menos três meses e clinicamente estáveis, sendo estes divididos em dois grupos de intervenção, grupo RCPM convencional (GC) e grupo de RCPM baseada em domicílio (GD). Os pacientes ingressaram no estudo, em momentos distintos, ao longo de 21 meses de coleta de dados. Foram avaliados os resultados referentes à aderência aos diferentes protocolos de intervenção e as barreiras, através da Escala de Barreiras para Reabilitação Cardíaca (EBRC). Os dados foram analisados por meio da estatística descritiva (média, desvio padrão e frequência), utilizando o programa estatístico Statistical Package for the Social Sciences -SPSS versão 20.0. Resultados: dos 11 pacientes, 5 foram alocados no GC e 6 no GD. Foi observada aderência superior no GD (106,3%) e o GC apresentou 86,1%. As principais barreiras encontradas no GD e GC foram "comorbidades/estado funcional" e "necessidades percebidas", respectivamente. Considerações Finais: a aderência ao programa de RCPM baseado em domicílio foi superior quando comparado ao grupo que realizou RCPM convencional supervisionada. Adicionalmente, as barreiras que mais influenciaram na obtenção destes resultados foram igualmente relatadas por ambos os grupos.Palavras-chave: Reabilitação; Exercício; Doenças Coronarianas. ABSTRACT Lately the home-based rehabilitation exercises has emerged as an alternative to the Cardiopulmonary and Metabolic Rehabilitation (CPMR

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“…Many studies have shown that a cardiac rehabilitation program consisting of aerobic and resistance training is an effective intervention to restore physical function 10,11) and exercise capacity, 12,13) and to reduce difficulty in physical activities of daily living 14,15) in cardiac patients. Several meta-analyses of randomized trials 12,16) have also confirmed that a cardiac rehabilitation program consisting of lifestyle modification and prolonged exercise training in the recovery phase (after hospital discharge) is more effective in reducing morbidity and mortality in cardiac patients. However, to our knowledge, this is the first study that adopted an exercise regimen to improve walking speed for a cardiac rehabilitation program during hospitalization, and that assessed the effects of inpatient cardiac rehabilitation on both walking speed at hospital discharge (short-term outcome) and cardiac events after hospital discharge (long-term outcome) in elderly patients with IHD.…”

Section: Discussionmentioning

confidence: 99%

Effect of Balance Training on Walking Speed and Cardiac Events in Elderly Patients With Ischemic Heart Disease

et al. 2014

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SummaryThe purpose of this study was to clarify the effect of standing balance training on walking speed (short-term outcome) and cardiac events (long-term outcome) in elderly ischemic heart disease (IHD) patients. This was a retrospective cohort study. Ninety-two elderly (≥ 65 years) IHD patients who underwent an inpatient cardiac rehabilitation program were assigned to two groups: a balance group that received standing balance training in addition to conventional (aerobic and resistance) training and a conventional group. Standing balance was assessed by one-leg standing time and a postural stability index reflecting dynamic balance, and normal walking speed was measured at baseline and hospital discharge. Patients were followed for up to 3 years or until a cardiac event occurred. There were no significant differences in clinical characteristics between the groups. Both groups showed a significant change in normal walking speed from baseline to hospital discharge (P < 0.001, respectively), and normal walking speed was significantly higher in the balance group compared to the conventional group (P = 0.001). The postural stability index improved significantly only in the balance group (P = 0.005). Multivariable analyses using Cox proportional hazards model confirmed that standing balance training (hazard ratio [HR]: 0.408; 95% confidence interval [CI]: 0.162-1.029; P = 0.058) and fast walking speed (HR: 0.362; 95% CI: 0.137-0.957; P = 0.041) were associated with cardiac events. These findings show that standing balance training improves walking speed and reduces cardiac events, and suggests that such training can be an effective intervention for elderly IHD patients. (Int Heart J 2014; 55: 397-403) Key words: Coronary artery disease, Standing balance, Aging, Secondary prevention, Cardiac rehabilitation D ecreased walking speed in elderly people is closely related to physical inactivity, difficulty performing physical activities of daily living, and health-related events.1-3) A 3-year prospective cohort study showed that wellfunctioning elderly people with a slow walking speed (≤ 90 m/ minute for men and ≤ 81 m/minute for women) have an almost 3-fold higher risk of cardiovascular mortality compared to those with a fast walking speed (> 111 m/minute for men and > 90 m/minute for women).3) Therefore, walking speed is considered a valuable parameter for assessing lower extremity functional status and prognoses such as disability, institutionalization, and/or mortality after adverse health-related events in community-dwelling elderly.In the clinical setting, walking speed tests at maximal or normal pace over 6 or 10 meters are also quick, safe, inexpensive, and reliable assessment tools. Ostir, et al 4) reported that cardiac patients have approximately a 5-to 8-fold greater degree of deterioration in lower extremity performance, including walking during hospitalization, compared to well-functioning elderly people. Moreover, clinical data 5) at hospital discharge reveal that walking speed in patients with acute m...

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Home-based versus centre-based cardiac rehabilitation

Cited by 123 publications

References 71 publications

A Review of Cardiac Rehabilitation Delivery Around the World

A Review of Cardiac Rehabilitation Delivery Around the World

Análise da aderência em diferentes programas de reabilitação cardíaca: estudo preliminar

Effect of Balance Training on Walking Speed and Cardiac Events in Elderly Patients With Ischemic Heart Disease

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